急性冠状动脉综合征患者血浆脂联素的变化

Study of the relationship of adiponectin development and plaque stability in patients with acute coronary syndrome

目的通过观察急性冠状动脉综合征(ACS)患者血浆脂联素(APN)水平的变化,推测APN与斑块稳定性的关系。方法选取经冠状动脉造影证实的冠心病患者75例,包括ACS患者(ACS组,36例)、稳定性心绞痛患者(SAP组,39例),并选取冠状动脉造影结果正常者为对照组(20例)。同时,根据造影结果对所有研究对象进行Gensini积分,分为0分组(20例)、1～30分组(45例)、≥30分组(30例)。ELISA检测所有研究对象血浆中APN水平变化。结果 (1)ACS组、SAP组血浆APN水平显著低于对照组,差异有统计学意义(P<0.05);(2)ACS组血浆APN水平显著低于SAP组,差异有统计学意义(P<0.05);(3)Gensini积分≥30分组APN水平显著低于<30分组,差异有统计学意义(P<0.05)。结论随着冠状动脉病变程度和不稳定性的加剧,APN在研究对象血浆中的水平逐渐降低,APN的降低可能加剧了病变处斑块的不稳定性,促进了动脉粥样硬化斑块的进程进展。

Objective To observe the changes of plasma adiponectin （APN） level in patients with acute coronary syndrome （ ACS）, and to study the relationship of APN and plaque stability. Methods Patients with coronary artery disease by coronary angiography in 75 cases divided into two groups：ACS group：patients with ACS （36 patients）and SAP group ：patients with stable angina pectoris（39 cases）. 20 hospitalized healthy volunteers with no clinical signs of CAD or coronary risk factors were studied as controls. Patients were divided into three groups according to Gemini score. The level of plasma APN was evaluated by ELISA. Results （ 1 ） The levels of APN in ACS group and SAP group were significantly lower than the control group, the difference were statistically significant （ P 〈 0. 05 ） ; （ 2 ） The levels of APN in ACS group was significantly lower than the SAP group, the difference were statistically significant（ P 〈 0.05 ） ;（3 ）The levels of APN in Gensini score over 30 group was significantly lower than Gensini score under 30 group, the difference were statistically significant （P 〈 0. 05 ）. Conclusions As the degree and the stability of coronary lesions is increasing, APN on the research object plasma of level gradually reduced. Explain the APN reduce may exacerbate the blockage plaques of stability, promote the atherosclerotic plaques development process.